Ogasawara Hirokazu, Morohashi Hajime, Sakamoto Yoshiyuki, Miura Takuya, Kagiya Takuji, Ogasawara Kenta, Takahashi Yoshiya, Hakamada Kenichi
Dept. of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2021 Mar;48(3):407-409.
The advantages of robot-assisted surgery include: stable deployment of the robotic arm that enables excellent radical cure characteristics and preservation of function; the ability to perform precise surgery even in patients in whom performing laparoscopic surgery is difficult, such as those with pelvic or bulky tumors. However, there have been some reports on such issues as an increase in the incidence of postoperative complications and an increase in postoperative hospital stay in patients who underwent neoadjuvant chemotherapy(NAC); thus, we summarized and are reporting the short-term results of our experience in patients seen in our department to date. A total of 76 patients with rectal cancer who underwent robot-assisted surgery, and short-term postoperative results were compared between patients who underwent neoadjuvant chemotherapy (NAC group)and those who did not undergo neoadjuvant chemotherapy(non-NAC group). Of the 76 patients, 59 (77.6%)were male and 17(22.4%)were female, and 27(35.5%)in the NAC group. In the comparisons between the NAC and non-NAC groups, although the difference in operative time(523.5 vs 317.5 minutes, p<0.01)was significant, there were no significant differences in any of blood loss(59 vs 20g, p=0.22), postoperative hospital stay(14 vs 13 days: p=0.07), and onset of complications that were Clavien-Dindo Grade Ⅲa or higher(2 vs 1 patients, p=0.82). Robot- assisted surgery after NAC for rectal cancer was considered to be safe and very useful.
机械臂部署稳定,能够实现出色的根治性切除并保留功能;即使对于那些进行腹腔镜手术困难的患者,如患有盆腔或巨大肿瘤的患者,也能够进行精确手术。然而,有一些报告指出了新辅助化疗(NAC)患者术后并发症发生率增加和术后住院时间延长等问题;因此,我们总结并报告了目前在我科就诊患者的短期经验结果。共有76例直肠癌患者接受了机器人辅助手术,并对接受新辅助化疗的患者(NAC组)和未接受新辅助化疗的患者(非NAC组)的术后短期结果进行了比较。76例患者中,男性59例(77.6%),女性17例(22.4%),NAC组27例(35.5%)。在NAC组和非NAC组的比较中,尽管手术时间差异显著(523.5对317.5分钟,p<0.01),但在失血量(59对20克,p=0.22)、术后住院时间(14对13天:p=0.07)以及Clavien-DindoⅢa级或更高等级并发症的发生率(2对1例患者,p=0.82)方面均无显著差异。NAC后机器人辅助直肠癌手术被认为是安全且非常有用的。